Analysis of ICAM-1 and HLA-DR expression on renal allograft aspirates

ICAM-1 and HLA-DR expressions were studied on parenchymal cells obtained by aspirative biopsies of renal allografts. Patients were evaluated during 3 months after transplantation. Conventional cytology and immunoperoxidase stainings using anti-ICAM-1 and anti-HLA-DR antibodies were employed. The value of the total corrected increment was significantly higher (p < 0.05) during acute rejection episodes than during acute tubular necrosis or stable renal function. The percentage of HLA-DR positive cells were higher in rejection than in stable function periods (p < 0.05). The percentage of ICAM-1 positive cells was higher in rejection than in acute tubular necrosis periods (p < 0.05). The sensitivities to the diagnosis of rejection were 71.8% (TCI), 68.4% (ICAM-1) and 55.0% (HLA-DR). The specificities were 87.3%, 81.3% and 68.4% respectively. Combinations of the tests resulted in increased sensitivity. We concluded that the use of these monoclonal antibodies improves the sensitivity of conventional aspiration cytology to the diagnosis of acute renal rejection.